SOFA Score in Sepsis and Septic Shock

SOFA Score

• The Third International Consensus Definitions for Sepsis and Septic Shock recommends using the SOFA score in critical care settings.
• SOFA scores range from 0 to 4 and assess parameters like oxygenation, blood pressure, platelet count, bilirubin, Glasgow Coma Scale score, urine output, and creatinine.
• A SOFA score greater than 2 suggests a 10% mortality risk in hospitalized patients with suspected infections.

Septic Shock

• A patient with septic shock requires vasopressors to maintain a mean arterial pressure of 65 mm Hg.
• Patients with septic shock also have a serum lactate level greater than 2 mmol/L.

Laboratory Testing

• Blood cultures can be helpful in treating septic patients, but only 30% to 50% of septic patients will have positive blood cultures.
• Decreasing thrombocytopenia (below 150 × 109/L) is a strong predictor of adverse outcomes in patients with sepsis.
• Hyperbilirubinemia (>1.2 mg/dL), renal insufficiency (creatinine >1.2 mg/dL), and low urine output are also indicative of adverse outcomes.

Sepsis Criteria and SOFA Score

• The Third International Consensus Definitions for Sepsis and Septic Shock recommend using the SOFA score in critical care settings for its predictive value for sepsis.
• The SOFA score assesses various physiological parameters, including oxygenation, blood pressure, platelet count, bilirubin, Glasgow coma scale score, urine output, and creatinine.
• Each parameter receives a score from 0 to 4, with a total score greater than 2 indicating a 10% mortality risk in hospitalized patients with suspected infections.

Septic Shock Criteria

• Septic shock is characterized by the need for vasopressors to maintain a mean arterial pressure of at least 65 mm Hg.
• Septic shock patients also have a serum lactate level greater than 2 mmol/L.

Laboratory Testing for Sepsis

• Blood cultures can be helpful in guiding treatment but only 30%-50% of septic patients have positive blood cultures.
• Decreasing thrombocytopenia (below 150 × 109/L) is a strong predictor of negative outcomes in sepsis.
• Hyperbilirubinemia (>1.2 mg/dL), renal insufficiency (creatinine >1.2 mg/dL), and decreased urine output are also indicative of adverse outcomes in sepsis.